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Peer-reviewedCC BY 4.0European Journal of Nuclear Medicine and Molecular Imaging

Differentiation of axial spondyloarthritis-related lesions from degenerative lesions on Na[18F]Fluoride PET/CT in a longitudinal dataset of patients with radiographic axial spondyloarthritis

  • Jerney de Jongh1
  • Sam Groothuizen1
  • Gerben J.C. Zwezerijnen2
  • Robert Hemke2
  • Tom Doorschodt3
  • Ralph Paul Maguire4
  • Tom Vaux5
  • Conny J. van der Laken1
5 affiliations
  1. 1Department of Rheumatology & Clinical Immunology, Amsterdam UMC, Amsterdam, The Netherlands
  2. 2Department of Radiology & Nuclear Medicine, Amsterdam UMC, Amsterdam, The Netherlands
  3. 3Department of Radiology & Nuclear Medicine, OLVG, Amsterdam, The Netherlands
  4. 4UCB Biopharma SRL, Brussels, Belgium
  5. 5UCB Pharma, Slough, United Kingdom
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Abstract

Purpose: To investigate longitudinal changes of Na[18F]Fluoride uptake in the axial skeleton of patients with radiographic axial spondyloarthritis (r-axSpA) during biological treatment, focusing on r-axSpA and degenerative (D) lesions.

Methods: 20 active r-axSpA patients were included. Na[18F]Fluoride Positron Emission Tomography / Computed Tomography (PET/CT) scans were performed prior to, as well as 12 and 52 weeks after starting biological therapy. PET-positive lesions in the axial skeleton were scored and classified by two blinded readers. Quantitative Na[18F]Fluoride uptake was assessed by determination of standardized uptake values (SUV) corrected for individual integrated whole blood activity concentration (SUVAUC).

Results: A total of 276 lesions with visual Na[18F]Fluoride uptake were detected, of which 98 (36%) were defined as r-axSpA and 46 (17%) as D. The total number of r-axSpA lesions decreased from 98 at baseline to 67 at week 12 (-32%) and to 55 at week 52 (-18%), while the number of D lesions remained stable over time. The majority of r-axSpA lesions were observed in the thoracic spine (84%), while the majority of D lesions were observed in the lumbar spine (48%). Quantitatively, 84% and 88% of the r-axSpA lesions showed a decrease of Na[18F]Fluoride uptake between baseline and 12 and 52 weeks, respectively. In contrast, most D lesions either showed an increase or mild decrease between baseline and follow-up.

Conclusion: Na[18F]Fluoride uptake in visually classified r-axSpA and D lesions in r-axSpA patients on PET/CT demonstrated a striking different change in both the number of r-axSpA lesions and quantitative tracer uptake herein versus D lesions while on biological treatment.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00259-026-08178-6.

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Cite

BibTeXRIS
BibTeX
@article{jongh2026differentiation,
  title = {{Differentiation of axial spondyloarthritis-related lesions from degenerative lesions on Na[18F]Fluoride PET/CT in a longitudinal dataset of patients with radiographic axial spondyloarthritis}},
  author = {Jerney de Jongh and Sam Groothuizen and Gerben J.C. Zwezerijnen and Robert Hemke and Tom Doorschodt and Ralph Paul Maguire and Tom Vaux and Conny J. van der Laken},
  journal = {European Journal of Nuclear Medicine and Molecular Imaging},
  year = {2026},
  month = oct,
  doi = {10.1007/s00259-026-08178-6},
  url = {https://doi.org/10.1007/s00259-026-08178-6},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Differentiation of axial spondyloarthritis-related lesions from degenerative lesions on Na[18F]Fluoride PET/CT in a longitudinal dataset of patients with radiographic axial spondyloarthritis
AU  - Jerney de Jongh
AU  - Sam Groothuizen
AU  - Gerben J.C. Zwezerijnen
AU  - Robert Hemke
AU  - Tom Doorschodt
AU  - Ralph Paul Maguire
AU  - Tom Vaux
AU  - Conny J. van der Laken
PY  - 2026
DA  - 2026/10/09
JO  - European Journal of Nuclear Medicine and Molecular Imaging
DO  - 10.1007/s00259-026-08178-6
UR  - https://doi.org/10.1007/s00259-026-08178-6
AB  - Purpose: To investigate longitudinal changes of Na[18F]Fluoride uptake in the axial skeleton of patients with radiographic axial spondyloarthritis (r-axSpA) during biological treatment, focusing on r-axSpA and degenerative (D) lesions.  Methods: 20 active r-axSpA patients were included. Na[18F]Fluoride Positron Emission Tomography / Computed Tomography (PET/CT) scans were performed prior to, as well as 12 and 52 weeks after starting biological therapy. PET-positive lesions in the axial skeleton were scored and classified by two blinded readers. Quantitative Na[18F]Fluoride uptake was assessed by determination of standardized uptake values (SUV) corrected for individual integrated whole blood activity concentration (SUVAUC).  Results: A total of 276 lesions with visual Na[18F]Fluoride uptake were detected, of which 98 (36%) were defined as r-axSpA and 46 (17%) as D. The total number of r-axSpA lesions decreased from 98 at baseline to 67 at week 12 (-32%) and to 55 at week 52 (-18%), while the number of D lesions remained stable over time. The majority of r-axSpA lesions were observed in the thoracic spine (84%), while the majority of D lesions were observed in the lumbar spine (48%). Quantitatively, 84% and 88% of the r-axSpA lesions showed a decrease of Na[18F]Fluoride uptake between baseline and 12 and 52 weeks, respectively. In contrast, most D lesions either showed an increase or mild decrease between baseline and follow-up.  Conclusion: Na[18F]Fluoride uptake in visually classified r-axSpA and D lesions in r-axSpA patients on PET/CT demonstrated a striking different change in both the number of r-axSpA lesions and quantitative tracer uptake herein versus D lesions while on biological treatment.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00259-026-08178-6.
SN  - 1619-7070
SN  - 1619-7089
ER  -